Negotiating Control: From Recognizing a Need to Making a Decision to Apply for a Housing Adaptation

Participation in Everyday Life Before and After a Housing Adaptation

“…However, the fact that they existed/persisted from early in the process is of considerable concern since it indicated that the needs evaluation wasn't complete. Similar results were found in previous Swedish studies (Ekstam et al, 2016;F€ ange & Iwarsson, 2007), highlighting that this could be a systematic flaw in the Swedish HA system. It is a challenge to conduct an HA that is sustainable and flexible when the client's need are shifting over time, but considering the whole picture and carefully examining every link in the chain could have a positive effect on both performance and participation for the client.…”

“…A recent qualitative study about the decision-making process around HA recognized that applicants expect the intervention to facilitate not only independent performance of activities but also subjective aspects, such as freedom and integrity (Ekstam et al, 2016). Among our participants in this study the expectations of the HA were not always met, and some participants had high expectations of what the outcome of the HA would be.…”

“…The HA application process has been described as often being preceded by the applicant's own negotiation process, where varying amounts of time are needed to come to a decision (Ekstam et al, 2016). This adds to the challenge of finding and installing the appropriate HA.…”

“…Clients who have high expectations of the outcomes of the HA more easily come to a decision to apply, compared with those whose expectations are lower (Ekstam, F€ ange, & Carlsson, 2016). Clients with high expectations expected that the HA would enable them to regain or increase their physical activities, gain more independence, freedom, and integrity, and remain living safely at home (Ekstam et al, 2016). In order to explore whether the expectations and influences of the HA on the clients' performance and engagement in everyday life are sustainable over time, both a short-and long-term perspective is important.…”

“…The short-term perspective is especially vital since it can capture possible improvements in performance and engagement during the first months after HA (Petersson et al, 2009). A more long-term perspective is needed to capture eventual changes in performance and engagement further down the line-for example, to explore whether or not the HA matched the initial expectations the clients had when they applied (Ekstam et al, 2016;F€ ange & Iwarsson, 2005a).…”